OBJECTIVE

To examine changes in lactobacilli composition in the vaginal microbiocenosis associated with bacterial vaginosis (BV) and to assess the frequency of individual species.

MATERIAL AND METHODS

The study included 40 patients who presented with pathological discharge from the genital tract and had a confirmed diagnosis of BV based on the Amsel criteria. Quantitative assessment and typing of lactobacilli were performed using real-time PCR.

RESULTS

All women with BV were found to have lactobacilli present in quantities ranging from 0.01% to 100% of the total bacterial content. Analysis of the distribution of the lactobacilli index (LI), which indicates the proportion of lactobacilli in the total bacterial content, revealed three peaks corresponding to samples with low, intermediate, and high values. During the typing, all four species of lactobacilli characteristic of the vaginal microbiocenosis were identified: L. iners, L. crispatus, L. jensenii, and L. gasseri/L. johnsonii. No samples were found that lacked at least one of these species; L. crispatus and L. iners were the most frequently detected. Despite a general trend toward decreased LI levels in BV, patients were categorized into three subgroups based on their LI values: high, moderately reduced, and low.

CONCLUSION

The positive correlation observed for L. iners and the negative correlation for L. crispatus with the degree of dysbiosis do not, in our opinion, reflect direct cause-and-effect relationships regarding BV, as these correlations are more closely associated with lactobacilli content than with clinical manifestations of the disease. A significant proportion of BV cases with the preservation of lactobacilli dominance suggests the existence of at least two forms of this syndrome. One of them, despite the presence of clinical symptoms, is not associated with a decrease in the number of lactobacilli in the vaginal microbiome.